HMH7 CONTRACTOR SPIFF UNIVERSAL FORM

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USE THIS FORM TO CLAIM YOUR YORK OR LUXAIRE HMH7 BONUS SPIFF NOW THROUGH JANUARY 31, 2023.

All claims must be submitted by February 28th, 2023.

Note: A valid W-9 is required for payment. You can send a copy of your W-9 to your Republic Territory Manager, or email an electronic copy to [email protected]

HMH7 CONTRACTOR SPIFF UNIVERSAL FORM

SYSTEM 1

Check the box below to confirm installation is in a Residential application(Required)
MM slash DD slash YYYY

SYSTEM 2

Check the box below to confirm installation is in a Residential application
MM slash DD slash YYYY

SYSTEM 3

Check the box below to confirm installation is in a Residential application
MM slash DD slash YYYY

SPIFF PAYMENT INFORMATION

Has this equipment been registered for warranty on HVAC Navigator?(Required)
All equipment must be registered in order to qualify for spiffs.
Check the box below to confirm you have submitted a valid W-9 form to your Republic Territory Manager or emailed to [email protected](Required)
This field is for validation purposes and should be left unchanged.